Minerva

Facing certain death from an unresectable and aggressive lung tumour, a 47 year old woman from Florida embarked on a cruise and a course of germanium, a controversial alternative treatment for cancer (Chest 2000;117:591-3). Her tumour and her symptoms disappeared, and she remains well four years after diagnosis. Oncologists are baffled. They had definitive histology of a spindle cell carcinoma, so must choose between two equally implausible explanations: spontaneous remission of the tumour or a real treatment effect from a toxic elemental metal that has failed to work in clinical trials of breast, prostate, and renal cancers. It's unlikely we will ever know.

Plain skull radiographs should be abandoned as a screening tool for intracranial bleeding in people with a mild head injury, write Dutch investigators after their meta-analysis showed that it has a sensitivity of only 38% (Journal of Neurology Neurosurgery and Psychiatry 2000;68:416-22). The low sensitivity means that a normal skull radiograph does not rule out serious internal bleeding, which occurs in about 8% of cases. The cornerstones of management are clinical triage, observation, and computed tomography for those at high risk, the authors say.

An observational study in Thorax finds a link between paracetamol consumption and asthma …